Donor anxiety, needle pain, and syncopal reactions combine to determine retention: a path analysis of two‐year donor return data

Abstract

BACKGROUND Efforts to expand the donor pool by recruiting younger donors have resulted in higher numbers of initial donations, but retention of young donors continues to be a problem. STUDY DESIGN AND METHODS Path analysis was used to examine the simultaneous relationships among syncopal reactions, donation anxiety, needle pain, donor satisfaction, and donation intention in the prediction of repeat donation. Participants included 421 first- and second-time donors recruited for a study comparing the effects of pre-donation water loading with and without the use of applied muscle tension during donation (52% female, 60.8% first-time donor, mean age 20.3 years). For this longitudinal follow-up study, donor database records were accessed two years after the index donation to determine whether a repeat donation had been attempted. RESULTS Results of a series of path analyses demonstrated the influential role of donor anxiety in shaping donor retention (final model Χ2=35.75, RMSEA=0.03, CFI=0.98, WRMR=0.74). First, anxiety exerted a direct negative influence on donation intention, the proximal and sole direct predictor of repeat donation. Second, anxiety increased the likelihood of donor-reported needle pain, adversely affecting donation satisfaction and, subsequently, donation intention. Finally, anxiety was associated with donor ratings of syncopal reactions through its impact on needle pain, which also contributed to decreased donation intention. CONCLUSION These results provide novel evidence that donation anxiety plays a central role in shaping future donation behavior; hence, individual differences in anxiety must be considered when developing and testing strategies to enhance blood donor retention.

Initial validation of a virtual blood draw exposure paradigm for fear of blood and needles

“…Further, the individual may find the symptoms distressing, thus promoting avoidance of future medical or otherwise important procedures [11,12,29].…”

Management of Young Blood Donors

“…A third study using the same 1,715 donors followed blood donor return rates over a 2-year period [66]. Fear decreased the blood donor return rate from 55% (no fear) to 45% (fear), but fear also affected the vasovagal reaction rate, and vasovagal reactions decreased the blood donor return rate from 56 to 36%.…”

“…A randomized study of 421 donors [66] did not show a 2-year return rate difference between college donors given water and muscle tension (9.9% vasovagal reaction rate) versus no interventions (17.9% vasovagal reaction rate). The return rates were 35% or 34%.…”

Fear of donation‐related stimuli is reported across different levels of donation experience

“…Whereas such stimuli undoubtedly deter a portion of the population from ever attempting to donate blood, for others both internal and external motivational forces encourage them to face their fear(s). While this decision is laudable, among blood donors higher anxiety has been related to greater needle pain, decreased donation satisfaction, increased risk for vasovagal reactions, and a decreased likelihood of repeat donation . Indeed, donors who report any level of fear in response to the question “How afraid are you of having blood drawn from your arm?” are more likely to experience a faint or prefaint reaction and are less likely to provide a future donation .…”